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  • Ann-Sophie Briest, MD

PAIN DOES NOT EQUAL PAIN

Updated: Aug 12, 2019

How often have you heard your Yoga teacher say: “Just breathe! Just breathe into that body part! Just breathe through the pain!”?

I’m sure we all have experienced moments during the yoga practice (or daily life) when a specific movement, stretch, or asana (posture) made you catch your breath. When the experience in that specific moment was almost overwhelming and hence for a second the breath (and body) would freeze. The attention was so caught up in this unusual and strong perception in the body that we would somehow forget to breathe.

It is true, holding the breath often adds extra tension and force to the body, while long, deep in- and exhalations support the relaxation of tissues. During the Yoga practice we aim to strengthen, relax and open ourselves, ultimately reconnecting with our most intimate sense of Self, of “I am”, thus moving from a state of doing into a state of being – being fully present to whatever is arising inside of us. But does “being fully present” also include physical pain? Should we just witness the sensation for what it is – no need to label, judge or change it? Should we just breathe through the pain? Or are there certain qualities and characteristics to pain which could help to safely evaluate the situation?


THE MEDICAL AND YOGA THERAPEUTIC PERSPECTIVE

For the modern Yoga practitioner these are relevant questions. We are in times of growing interest in the healing properties of Yoga but also increasing numbers of articles and studies on 'Yoga injuries'. Hence I gladly share my medical and Yoga Therapy perspective on pain with you, hoping to support a mindful and safe practice which allows you to taste the transformative power of Yoga.

In the tradition there are numerous methodologies – mainly meditation techniques – which teach the practitioner, through a static posture and strong inner witness, to witness occurring pains in the body. Without belittling the efficacy of those powerful ancient techniques, I attempt to offer a more therapeutic, modern perspective on pain perception during Yoga practice in this article.

First of all, we need to understand that pain does NOT equal pain. Pain and its intensity is a subjective phenomenon which depends on a multitude of factors such as:

  • the anticipation of pain

  • the sensitization of both pain receptors (called nociceptors) and certain centres in the brain

The fact that we possess nociceptors in most of our bodily tissues is a genius protective mechanism which helps detect tissue damage. Thus, pain during the Yoga practice may actually act as an early-warning system to prevent injuries. Breathing or encouraging students to breathe through a pain that indicates tissue damage is in my therapeutic understanding obviously dangerous and even grossly negligent. We could call this form of alarming pain “bad” or “red flag” pain and we aim to avoid it at all times.

On the other hand, I’m sure we can all recall a memory of entering an asana and being confronted with a certain level of discomfort, tension or even pain. Only to find out that a few breaths later that same discomfort had changed into a pleasant feeling of releasing stress and inner contractions from the body. We could call this form of inoffensive pain “good” or “green flag” pain and we can utilise our breath to effectively release stored tensions from the body and mind.


Here are a few more guidelines and ideas which may help your own practice or teachings to promote healthy and safe explorations of the yogic system.

“Red flags”

  • A strong tension or pain which occurs suddenly while entering, holding or coming out of an asana

  • Any sharp or electrifying pain

  • Prolonged, intensive pain after the yoga practice

  • Numbness of body parts that remains after releasing a posture

“Green flags”

  • An initial, gentle tension which can be perceived in the beginning phase of an asana and is due to stretching fascia (and muscles) or when moving the body into or out from unusual positions (i.e. inversions).

  • The pain should be mild in nature and cease soon after the posture is comfortably entered or released

  • Numbness of limbs (especially after prolonged sitting postures) may be acceptable as long as the tingling ceases immediately afterwards


This is a general guidance which aims to improve mindfulness and respect for your own limitations during the Yoga practice. When in doubt whether you are still with a “good” pain or not please, as well as being extremely gentle with your body, also consult your Yoga teacher or therapist. Wishing you the best of health and joy in your Yoga practices.


Hoping to welcome you in one of our Samarasa Healing continued education programs, retreats or workshops.

Namaste, Ann-Sophie Briest

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